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This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction: hematological disorders constitute one of the most interesting problems to be considered by the stomatologist in his daily practice. Objective: to characterize the comprehensive stomatological care in patients with hematological diseases at the Provincial Pediatric Teaching Hospital 'Pepe Portilla' in the period from September to September Methods: An observational, descriptive, cross-sectional study was developed with the purpose of characterizing the comprehensive stomatological care in patients with hematological diseases at the 'Pepe Portilla' Pediatric Provincial Teaching Hospital, from September to September The universe and the sample consisted of 21 patients, the sample was selected intentionally, according to the inclusion and exclusion criteria. The data were obtained from the clinical history of the patients. Descriptive and inferential statistical methods were used to describe the variables. Conclusions: Most of the patients examined presented poor oral hygiene. Pharmacological prophylaxis was the most used method prior to stomatological treatment. Supportive physiotherapy, analgesia and antimicrobial therapy were part of the treatment for all postsurgical complications. There are multiple clinical manifestations of hematologic diseases, so it is vital to identify these pathologies in order to diagnose and apply an adequate treatment that responds to the needs of the patient's disease through a correct anamnesis, clinical examination and complementary tests. These constitute a very diverse group of diseases whose classification depends on the affected component. There are many pathologies of this origin that occur in pediatric ages, but there is no solid worldwide registry that collects reliable statistics for real studies on the morbimortality of these diseases. Only some countries in America, Europe and Asia show an important effort for the statistical and medical control of these diseases. The timely identification of these signs through a thorough physical examination and complete medical history prevents complications in the patient that could put his life at risk, so that when any sign suggestive of a hematological disorder is found, the patient should be referred to the hematologist. The stomatologist should be able to identify the different signs in the oral cavity that could suggest that the patient has a hematologic disorder, which could complicate dental treatment. Even with the knowledge of the specialist in hematology, the stomatologist should have full knowledge about these pathologies, their different clinical characteristics, oral manifestations, medical treatment of patients and the possible complications that may appear by performing minor surgical procedures, knowing in depth how to act in case of a complication and the medication that the patient has indicated. The bibliography consulted allowed us to detect certain limitations in the subject. There are few studies worldwide that show a permanent follow-up of these pathologies and their epidemiological behavior by the different health systems. In addition, there is a gap between the theory proposed decades ago and the present time, and there is a need to update everything related to the ideal management protocols for pediatric patients with pathologies of this nature. In spite of having protocols for the stomatological care of patients with hematological disorders, there is an urgent need to give them greater importance, update them and bring them up to date with the new studies in the field of hematology, giving greater importance to preventive work and thus guaranteeing a lower number of complications before, during and after dental treatment. Due to the importance of evaluating all these particularities in the hospital context, this research is carried out with the objective of characterizing the comprehensive stomatological care in patients with hematological diseases in the Provincial Pediatric Teaching Hospital 'Pepe Portilla', in the period from September to September The universe was integrated by the totality of patients who attended the Oncohematology Service during the period established for the research. A total of 21 patients, whose ages ranged from 1 to 18 years old. The sample was selected intentionally and was constituted according to the inclusion and exclusion criteria. Patients with a general health condition that prevents them from being examined and receiving conventional stomatological treatment. The variables analyzed were: age, sex, race, health area, clinical manifestations, hematologic disease, lesion location, level of oral hygiene, required stomatological treatment, measures prior to stomatological treatment, post-surgical complications and emergency behavior to be followed. The research was carried out under the dialectical materialistic approach as a general method of sciences. Based on it and for the development of scientific tasks, different theoretical, empirical and statistical methods of scientific research were combined. From the theoretical level, the historical-logical one that allowed to deepen in the antecedents and in the current tendencies of the object that was investigated, when punctuating the current approaches of this object. Documentary analysis: to obtain information contained in governing documents clinical records of hospitalized patients. Statistics: Simple frequency distributions were obtained for all the variables included in the study. For a better understanding, these were presented in contingency tables, using absolute and relative frequency parameters. A bivariate analysis was performed to describe the behavior of some categorical variables and the Chi-square test was used to determine their statistical correlation. The principles of medical ethics and the aspects established in the Declaration of Helsinki were complied with. Table 1: Distribution of patients according to sex and race. It was evidenced that intraoral manifestations had a greater presence compared to extraoral manifestations in a proportion of 1. Table 2: Distribution according to location of the lesions and the hematological disease diagnosed. Many of the patients. Table 5: Preliminary measures according to the type of stomatological treatment required. The patients who attended immediately received analgesia and physiotherapy. Regarding complications after the first 24 hours, there was only one patient who could not be seen immediately for treatment. Parra and Rodriguez 6 state that the most common clinical manifestations of anemia and erythrocyte disorders are pallor and atrophy of the mucous membranes, depapillated tongue, glossitis, angular cheilitis, oral candidiasis, delayed wound healing after oral surgery, ulcers, glossodynia and dysphagia. Regarding hemostasis defects, epistaxis, petechiae and ecchymosis in skin and mucous membranes are the most common. Spontaneous gingival hemorrhage is very frequent at intraoral level, causing brown deposits on the teeth due to hemosiderin and other waste products. Likewise, other disorders such as neutropenia cause premature tooth loss, recurrent deep and large ulcers that persist, covered by a whitish pseudomembrane surrounded by mild erythema. Periodontal involvement may present as gingivitis, periodontitis or stomatitis with ulceration. Regarding hemostasis disorders, Medeiros et al. Suquilanda 9 found that the average age was 56 years with a progressive increase after 60 years of age. Shimizu et al. Tangudu et al. Antonini et al. The dentist is one of the first health professionals who can detect the signs and symptoms of leukemia. So you can order tests to confirm the suspicion of a possible alteration; this allows a quick and early diagnosis; which favors a better prognosis for patients. In the multidisciplinary oncology team, the dentist contributes to the medical team before, during, and after the medical examination and treatment. Mojica Lobo et al. There was a predominance of clinical manifestations such as mucositis in Less prevalent oral manifestations such as dental caries, trismus and geographic tongue were also found. Antiplatelet drugs and anticoagulants have been associated with increased bleeding time and increased risk of postoperative bleeding. However, stopping the use of these drugs exposes the patient to vascular problems with possible significant morbidity. Furthermore, in many cases, surgical suturing is not even necessary. Malden et al. This increase appears to be related to multiple or surgical extractions. However, it is not related to sex, preoperative intake of antibiotics or simple procedures that most affected the probability of coagulation problems. For these authors, patients undergoing oral anticoagulation and requiring dental extractions constitute a common problem in dental practice; although most warfarin-related bleeding occurs when the INR is above 3. It is concluded that male sex, ages between 7 and 12 years old and patients with white skin predominated. Most of them belonged to health areas corresponding to the municipal capital, and intraoral manifestations were more frequent, with anemia and erythrocyte disorders predominating. Most of those studied presented poor oral hygiene. They coincided with at least one type of oral manifestation. The great majority required conservative treatment, followed by surgical treatment and finally preventive treatment. Pharmacological prophylaxis was the most commonly used method prior to stomatological treatment. 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The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again. Their professionalism is apparent and more than satisfactory. Susan Weiner. Toggle navigation. Explore journals Our Services Reprints and permissions. Comprehensive dental care in pediatric patients with hematological diseases Home Journals Journal of Thoracic Disease and Cardiothoracic Surgery Archives. Submit Guidelines. Abstract Introduction Discussion References. Quick Links. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited Received: 13 September Accepted: 20 September Published: 09 October Keywords: hematologic diseases; signs and symptoms; antimicrobial; patients. Abstract Introduction: hematological disorders constitute one of the most interesting problems to be considered by the stomatologist in his daily practice. Methods An observational, descriptive, cross-sectional study was carried out with the purpose of characterizing the comprehensive stomatological care in patients with hematological diseases at the 'Pepe Portilla' Pediatric Provincial Teaching Hospital from September to September Inclusion criteria Patients with previously diagnosed hematologic pathologies. Patients whose parents signed the informed consent form Exclusion criteria Patients under study, without a definitive diagnosis of their basic pathology. Empirical: Documentary analysis: to obtain information contained in governing documents clinical records of hospitalized patients. Regarding these results, Haider et al. Sindet-Pedersen et al. Conflict of interest The authors declare that there is no conflict of interest. Authors' contribution All authors participated in the conceptualization, formal analysis, project management, writing - original draft, writing - revision, editing and approval of the final manuscript. Funding The authors did not receive funding for the development of this research. Comportamiento, La Habana; Validation of the revised international prognostic score of thrombosis for essential thrombocythemia IPSETthrombosis in Mayo clinic patients. Am J Hematol \[Internet\]. Corpus et Scientia \[Internet\]. Unusual maxillary osteoblastic and osteolytic lesions presenting as an initial manifestation of childhood acute myeloid leukemia: A case report. Quintessence Int \[Internet\]. Oral manifestations associated with neutrophil deficiency and neutrophil disorders: A review. IAIM \[Internet\]. Antibacterial prescribing and warfarin: a review. British Dental Jounal\[Internet\]. Dental management of patients receiving anticoagulation or antiplatelet treatment. J Oral Sci\[Internet\]. Thromboembolic risk and bleeding in patients maintaining or stopping oral anticoagulant therapy during dental extraction. J Thromb. Hemostatic effect of tranexamic acid mouth washing anticoagulant-treated undergoing oral surgery. N Engl J Med\[Internet\]. Minor oral surgery and interference with anticoagulation in patients taking warfarin :a retrospective study. View at Publisher View at Google Scholar. Mina Sherif Soliman Georgy. Anthony Kodzo-Grey Venyo. Gomez Barriga Maria Dolores. Maria Dolores Gomez Barriga. Dr Maria Dolores Gomez Barriga. Dr Maria Regina Penchyna Nieto. Anemias and erythrocyte disorders. Neoplasms Hemolympho poietic.
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